ADVENTIST HEALTH CLEARLAKE HOSPITAL
15630 18th Ave, Clearlake, CA · Adventisthealth · · NPI 1124018031
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Tp53 gene full gene sequence CPT 81351 | $349.20 | $970.00 | $273.00 – $4,243.11 | 7 |
| Tp53 gene trgt sequence alys CPT 81352 | $118.80 | $330.00 | $263.61 – $2,178.26 | 7 |
| Tpmt gene com vrnts CPT 81335 | $113.76 | $316.00 | $139.85 – $2,437.42 | 7 |
| Trabeculoplasty laser surg CPT 65855 | $205.20 | $570.00 | $286.67 – $940.50 | 3 |
| Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution HCPCS J3290 | $13.81 | $38.37 | $38.37 – $38.37 | 3 |
| Transferrin CPT 84466 | $58.32 | $162.00 | $1.40 – $153.62 | 7 |
| Transfusion blood/blood component(s) CPT 36430 | $527.04 | $1,464.00 | $1,464.00 – $2,415.60 | 3 |
| Trauma partial team response w/critical care services level 4 HCPCS G0390 | $5,399.28 | $14,998.00 | $5,597.00 – $9,235.05 | 3 |
| Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour CPT 94644 | $223.92 | $622.00 | $24.38 – $1,026.30 | 8 |
| Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour CPT 94645 | $138.60 | $385.00 | $17.79 – $635.25 | 8 |
| Treatment inhalation pressurized/nonpressurized acute airway obstruction CPT 94640 | $432.36 | $1,201.00 | $16.78 – $543.00 | 8 |
| Treponema pallidum antibody CPT 86780 | $119.88 | $333.00 | $1.44 – $323.69 | 7 |
| Trg gene rearrangement anal CPT 81342 | $93.60 | $260.00 | $118.50 – $1,336.80 | 7 |
| Triamcinolone acetonide 40 mg/ml suspension for injection HCPCS J3301 | $26.68 | $74.12 | $2.01 – $29.65 | 8 |
| Triamcinolone diacetate inj HCPCS J3302 | $40.32 | $112.00 | $0.89 – $112.00 | 8 |
| Trichinella antibody CPT 86784 | $34.16 | $94.90 | $11.92 – $147.56 | 7 |
| #tricyclicantidprssnt CPT 80337 | $50.86 | $141.28 | $5.00 – $384.37 | 7 |
| Triglycerides CPT 84478 | $53.64 | $149.00 | $0.29 – $66.90 | 7 |
| Troponin quantitative CPT 84484 | $114.48 | $318.00 | $1.06 – $223.04 | 7 |
| Tympanometry & reflex thresh CPT 92550 | $140.76 | $391.00 | $25.35 – $645.15 | 3 |
| Ua w/micro/comp poc CPT 81000 | $16.20 | $45.00 | $1.81 – $36.91 | 7 |
| Ugt1a1 gene analy common variants CPT 81350 | $83.57 | $232.13 | $232.13 – $700.98 | 7 |
| Ultrasound abdomen aorta screening study aaa CPT 76706 | $369.00 | $1,025.00 | $122.57 – $1,691.25 | 6 |
| Ultrasound breast complete CPT 76641 | $441.72 | $1,227.00 | $140.05 – $1,349.70 | 6 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $335.88 | $933.00 | $114.74 – $910.80 | 6 |
| Ultrasound chest CPT 76604 | $424.08 | $1,178.00 | $99.17 – $862.95 | 6 |
| Ultrasound encephalogram CPT 76506 | $142.92 | $397.00 | $89.26 – $655.05 | 6 |
| Ultrasound exam k transpl w/doppler CPT 76776 | $48.60 | $135.00 | $135.00 – $626.53 | 6 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $612.72 | $1,702.00 | $117.20 – $549.72 | 6 |
| Ultrasound guidance for vascular access CPT 76937 | $23.40 | $65.00 | $40.38 – $149.84 | 6 |
| Ultrasound guided needle placement supervision & interpretation CPT 76942 | $744.12 | $2,067.00 | $76.77 – $1,402.50 | 6 |
| Ultrasound guide intraoperative CPT 76998 | $245.88 | $683.00 | $569.31 – $1,126.95 | 6 |
| Ultrasound guide tissue ablation CPT 76940 | $133.20 | $370.00 | $370.00 – $610.50 | 6 |
| Ultrasound infant hips ltd without stress CPT 76886 | $338.76 | $941.00 | $97.27 – $1,552.65 | 6 |
| Ultrasound joint complete left CPT 76881 | $399.24 | $1,109.00 | $150.76 – $778.80 | 6 |
| Ultrasound joint/nonvascular extremity limited left CPT 76882 | $331.56 | $921.00 | $37.65 – $397.65 | 6 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $86.40 | $240.00 | $120.06 – $907.88 | 6 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $69.84 | $194.00 | $82.13 – $268.95 | 6 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $358.92 | $997.00 | $232.99 – $1,244.72 | 6 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $262.08 | $728.00 | $74.36 – $691.35 | 6 |
| Ultrasound pregnant uterus limited >= 1 fetuses CPT 76815 | $333.00 | $925.00 | $90.30 – $575.85 | 6 |
| Ultrasound pregnant uterus transvaginal CPT 76817 | $211.68 | $588.00 | $117.86 – $523.67 | 6 |
| Ultrasound prostate/transrectal CPT 76872 | $404.64 | $1,124.00 | $97.04 – $455.83 | 6 |
| Ultrasound retroperitoneal limited CPT 76775 | $479.88 | $1,333.00 | $73.70 – $1,615.35 | 6 |
| Ultrasound scrotum and contents CPT 76870 | $522.00 | $1,450.00 | $85.75 – $1,011.45 | 6 |
| Ultrasound spinal canal and contents CPT 76800 | $122.04 | $339.00 | $116.16 – $559.35 | 6 |
| Ultrasound transvaginal non obstetric CPT 76830 | $433.08 | $1,203.00 | $97.04 – $900.90 | 6 |
| Unlisted misc path test CPT 89240 | $3.37 | $9.35 | $9.35 – $9.35 | 1 |
| Unlisted procedure microbiology CPT 87999 | $159.48 | $443.00 | $443.00 – $443.00 | 4 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $2,233.08 | $6,203.00 | $554.74 – $9,641.34 | 8 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $1,512.00 | $4,200.00 | $442.89 – $6,930.00 | 8 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $1,545.48 | $4,293.00 | $394.99 – $6,172.65 | 8 |
| Urea nitrogen CPT 84520 | $40.32 | $112.00 | $0.12 – $46.12 | 7 |
| Urea nitrogen 24 hour urine CPT 84540 | $168.12 | $467.00 | $0.31 – $55.48 | 7 |
| Urea nitrogen clearance CPT 84545 | $2.12 | $5.88 | $0.42 – $77.13 | 7 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $418.32 | $1,162.00 | $59.56 – $1,917.30 | 8 |
| Urethrocystography void s&i CPT 74455 | $816.12 | $2,267.00 | $86.91 – $3,740.55 | 8 |
| Uric acid blood CPT 84550 | $48.96 | $136.00 | $0.33 – $52.89 | 7 |
| Uric acid urine CPT 84560 | $34.56 | $96.00 | $0.21 – $55.48 | 7 |
| Urinalysis microscopic only CPT 81015 | $30.60 | $85.00 | $2.59 – $35.49 | 7 |
| Urinalysis (with microscopy) CPT 81001 | $30.60 | $85.00 | $0.09 – $35.73 | 7 |
| Urinalysis (without microscopy) CPT 81003 | $28.80 | $80.00 | $0.04 – $26.29 | 7 |
| Urine Culture Test CPT 87086 | $103.32 | $287.00 | $9.25 – $93.02 | 7 |
| Urine pregnancy test CPT 81025 | $62.64 | $174.00 | $0.74 – $59.65 | 7 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | $153.00 | $425.00 | $288.47 – $701.25 | 6 |
| Vaccine dtap < 7 years im CPT 90700 | $37.08 | $103.00 | $11.00 – $100.85 | 8 |
| Vaccine dtap-hep b-ipv im CPT 90723 | $106.20 | $295.00 | $11.00 – $361.28 | 8 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | $81.72 | $227.00 | $11.00 – $214.24 | 8 |
| Vaccine dtap-ipv/hib im CPT 90698 | $107.64 | $299.00 | $11.00 – $384.62 | 8 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | $24.84 | $69.00 | $23.00 – $140.87 | 8 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | $38.52 | $107.00 | $11.00 – $66.66 | 8 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | $70.56 | $196.00 | $129.50 – $323.40 | 8 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | $285.84 | $794.00 | $194.11 – $1,310.10 | 8 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | $48.60 | $135.00 | $11.00 – $117.10 | 8 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | $43.92 | $122.00 | $122.00 – $204.60 | 9 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | $82.44 | $229.00 | $111.79 – $377.85 | 9 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | $48.60 | $135.00 | $135.00 – $483.40 | 9 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $47.39 | $131.63 | $11.00 – $90.39 | 9 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | $183.60 | $510.00 | $11.00 – $1,074.73 | 8 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | $155.16 | $431.00 | $11.00 – $355.22 | 8 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | $37.80 | $105.00 | $57.69 – $267.23 | 9 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | $162.36 | $451.00 | $111.47 – $586.91 | 9 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | $31.98 | $88.83 | $30.30 – $92.40 | 9 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | $19.80 | $55.00 | $11.00 – $41.99 | 7 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | $53.28 | $148.00 | $39.57 – $244.20 | 6 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 | $22.32 | $62.00 | $45.52 – $102.30 | 7 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | $24.12 | $67.00 | $11.00 – $49.90 | 7 |
| Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im CPT 90687 | $19.80 | $55.00 | $17.95 – $90.75 | 7 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | $22.32 | $62.00 | $46.07 – $102.30 | 7 |
| Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 | $65.88 | $183.00 | $75.13 – $301.95 | 7 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | $33.12 | $92.00 | $43.00 – $134.77 | 9 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | $142.56 | $396.00 | $62.00 – $820.61 | 8 |
| Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 | $117.00 | $325.00 | $42.00 – $2,299.65 | 8 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | $137.52 | $382.00 | $11.00 – $576.91 | 8 |
| Vaccine mmr live subcutaneous CPT 90707 | $120.96 | $336.00 | $11.00 – $318.91 | 8 |
| Vaccine mmrv live subcutaneous CPT 90710 | $35.64 | $99.00 | $11.00 – $943.07 | 8 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | $91.08 | $253.00 | $11.00 – $363.38 | 9 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | $156.24 | $434.00 | $11.00 – $701.99 | 9 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | $268.20 | $745.00 | $497.11 – $1,131.90 | 8 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | $41.40 | $115.00 | $11.00 – $155.78 | 8 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.